Urea breath test (UBT)

The Urea Breath Test (UBT) measures radio-labeled carbon dioxide released through
the breath when urease, the enzyme produced by H. pylori, breaks down a sample
of C13- or C14-labeled urea. The UBT:

Is indicated for patients 18 years of age or older and should be administered by
trained office staff

Requires that the patient ingest a standard sample of labeled C13 or C14 and, at
a predetermined time, produce a breath sample

Requires a mass spectrometer or scintillation counter

Patients are required to be off the following medications. Proton Pump inhibitors,
Bismuths, and antimicrobials two weeks prior to being tested.

Patient procedure requires that the patient ingest a citric solution that contains
Phenylalanine.

False positive tests could occur in patients who have achlorhydria.

Serologic antibody testing

The American Gastroenterological Association no longer recommends serologic antibody
testing either for primary diagnosis, or to confirm eradication of H. pylori.2
Serologic antibody tests do not distinguish between currently active infection
with a past exposure, or an infection that has been cured.

"The accuracy of serologic tests has been questioned, and the stool antigen test
and the urea breath test are therefore recommended for both the initial diagnosis
and for confirmation of eradication. Use of serologic testing for the initial diagnosis
of H. pylori requires its validation at a local level. This is difficult
to accomplish in routine practice; therefore, for practical purposes, serologic
testing for H. pylori is no longer recommended."2

Invasive testing

Invasive testing methods (i.e. histology, rapid urease testing, and culture) are
based on endoscopy and biopsy. These techniques are reserved for patients who: